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Depression

I’m Stuck

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP October 1st, 2019
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I’m a 17-year-old guy who lives in the UK and a few months ago I paid for a plane ticket for y girlfriend who lives in the US to come a stay with my family and me for 3 weeks, we had our fights when we were here but nothing serious. When she was leaving I wasn’t sure whether to break up with her or keep it going. Well I started talking to her cousin and things got kind of sexual. My girlfriend finds out and pretty much breaks up with me and tells me that she’s pregnant. Well after a while I’ve managed to get her to give me another chance to be perfect for her because when I look back I see that we really were happy together and I loved her so very much…I guessing just had a moment of weakness, I’m ashamed of what I did to her and I want to live the rest of my life with her, marry her and have more children with her like we planned before I talked to her cousin. It’s not the relationship I’m worried about because I know that over time we can move past it. I am worried about money, I have just finished an apprenticeship and there is no work for me…I need to pay for my girlfriend to come and live here as well as the baby which will be around £3500 or $6000 a year and then if she’s to stay here with me and the baby as a family the easiest visa to get would be a marriage visa and marriages are expensive. I’m worried about money but it’s not what I’m here for…I’m only 17, a very mature 17 year old I’ll grant you that but still…it’s a lot for me to sort out because we haven’t told our parents she’s pregnant yet…I know my parents will help us completely but after what happened my girlfriends mom hates me. I just need a way to sort of forget about everything that’s going on and relax…there’s just so much for me to deal with and I’m only 17 years old, I’ll be 18 when the baby is born and my girlfriend will be 16 when the baby is born. I know that I can do this but I can’t on my own for much longer…my girlfriend tends to leave things to the last minute which I don’t. I guess this is more of a release for me to just tell everything to someone without fear…just to get everything of my chest and take a weight off of my shoulder before it’s all put back on again. I’m ready to be a father I’m just not financially ready…sometimes I just don’t know what to do anymore.

It sounds very complex, but let’s see if we can sort it through. The first thing I would do is look to see what services might be available for your girlfriend. I would check your local hospital to find out what they know about helping unmarried teenagers. Typically there are many counseling, medical, and infant care programs that are available. You do not have to figure this out alone. I would encourage your girlfriend to check out the same resources at a local hospital or Planned Parenthood site near where she lives.

Second, your apprentice program should have a way of getting you networked into the field you have chosen. Get busy networking yourself into your chosen field so that even if you have to take another job right now, you will be ready when the opportunity to join your profession comes along.

Finally, let your parents help. Family is there for times like this. Let them help in whatever way they can.

You have the desire to change and be more than you are right now. This is a very good thing. That kind of motivation will help you look at what needs to be done, and find a way to make it work. I would get the counsel of family and the experts at the hospital so you and your girlfriend can make the best decisions possible.

Wishing you patience and peace,
Dr. Dan

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Unemployed husband is blowing money!

by Dr. Marie Hartwell-Walker August 20th, 2019
written by Dr. Marie Hartwell-Walker

My husband lost his second job in 4 years last Oct/Nov. He never really helped with the house or the two younger kids, 10 and 7, before he lost his job and always spent extravegently. But with him being off work for so long this time I hoped he would have made some effort to help out, especially since we are about to have a fourth child and I have started to have to work over time to make ends meet, and at least stop spending the way he does.
So far in the last year he has went to Florida twice, Colorado once (where he took in a baseball game, rented three cars- two at $400 a day to four wheel and one just to drive around), and Indianapolis (where he went to the Indianapolis 500). He is shopping constantly, spending 1000’s on fixing his numorous cars, spending at least two nights a week at bars with friends (where I usually have to come pick him up), and spending 100’s a month on his daughter, 15.
Since I am working over time he has been left in charge of our two younger girls at night and homework is not getting done, he doesn’t feed them dinner (I do ususally around 8:30-9), the kids are constantly calling me at work after school because he is watching TV in his room and refuses to make himself avaliable to them. The house is a complete disaster as well.

Every night he tells me tells he’ll work on the house and make sure the kids are taken care of tomorrow, but it never happens. Eventually I get so fed up that we end up arguing and I feel horrible having to point out all of his short comings during this time. When i ask him to at least give me a reason he couldn’t do what he promised or account for the 6 hours he is home alone while the kids are at school he just says he had other things to do and if he gives me more then that it seems as though he is making it up. I am never sure if he is making up what he is doing durning the day to cover up something or if he really has no sense of the time frames he is doing things in.

It is fair to mention he does have ADD and has always refused to take his medicine regularly. Since he has been off work he has admitted to not taking it most days. As well he has admited to needing to nap from 9-11 in the morning and again from 2- when the girls get off school, not sure if this has anything to do with him not managing his ADD or depression. At this point I am not sure whether to be concerned with his drinking, but I do think it will be an issue later.

I have talked to him about going back into counseling (we did family and couples counseling for three years but stopped once my work insurnace changed and would not cover the counselor we were seeing) but he always has an excuse not to. I have made two appointments with two counselors and he never showed up to either one.

I am just at my wits end at this point as the baby is due in a month and our house is definitely not fit for any kid to live in and I am not sure if there will be money in the bank account to cover our household expenses for much longer if he continues to spend like he is.

Your husband is in serious denial and so are you. He’s pretending he doesn’t have responsibilities as a husband and father. You are pretending that you can keep your financial boat afloat by throwing money at the situation. It isn’t working. It’s as if you are trying to fill a pitcher that has a hole in the bottom. Of even more concern is that you are in denial about the care your children are getting from him. This isn’t a safe or healthy situation for them.

I absolutely sympathize with the stress that unemployment can put on a guy. But the answer is not to sink the family. He could be giving you the emotional and practical support you need to provide for the family. Yes, it is a reversal of the traditional roles. But having one parent at home and one parent providing is a model that women have accepted and done well for generations and more and more men are embracing. It’s a model that can and does work. If he can’t find a job, your husband needs to do the job of taking care of the house and children so that you can perform well. As many, many men and women can tell him, that can be as rewarding and dignfying as any employment.

Your husband is too depressed to make a change so it’s up to you. For the sake of all your children, including the baby to come, separate your money. The money your husband has wasted could have gone to good childcare and some household help. Give him a modest allowance but that’s it, no exceptions, until he becomes a solid contributing partner. Make sure you are not responsible for any credit cards he has in his possession. You may need to see a lawyer to make sure you are not left holding the bag if he defaults on his financial obligations. Demand that your husband get into serious treatment, take his medications, and put himself on a money diet. He should probably sell some of the cars and stay out of the bars. Without money, he won’t be able to escape the reality that he is in serious trouble. When you stop cooperating with his denial, he’ll be less able to keep up the pretense of being among the privileged rich.

If your husband can’t or won’t man up, you have difficult decisions to make. Your first obligation is to the safety and welfare of your kids.

I realize that it’s terribly hard to make ultimatums to someone you love. But without a cold splash of reality, there is no reason for your husband to change. Wake up and get busy. Your new baby as well as your older kids deserve to have a more relaxed mom and a more responsible dad.

I wish you well.
Dr. Marie

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Early Signs of Schizophrenia?

by Kristina Randle, Ph.D., LCSW January 20th, 2020
written by Kristina Randle, Ph.D., LCSW

Please help me: I realize that these questions must become particularly redundant and for that I apologize. Instead of giving you a laundry list of assumptions, I will just explain how I feel and let you tell me the rest. The most noticable thing is that I often find it hard to put what I am feeling or thinking into words. I also tend to feel slightly reclusive and can never seem to socialize as I used to. I often find myself lost in thought and have tried add medicines without results. I find myself believing that my life has no meaning and no matter how well I fulfill my dreams and aspirations I will only be forgotten with time. I act out violently and do so consciously. At the time, my decisions feel like the right thing to do and I always seem to blame the bad outcome on others for not understanding me and being ignorant and/or arrogant. Even my parents just scold me and they’re supposed to be the ones who understand and know what I’m going through. I feel as if everyone functions differently than I do mentally. As if they do not realize things that I do and it always seems as if everyone is against me. whenever I notice people laughing or giggling or even just talking in soft tones,I always feel like they’re laughing at or talking about me. Always in a negative way. Due to this I have developed a particularly low self-esteem. I often feel stressed out and as though nobody else understands what that stress is like. I’m usually humbled, but my brains have always been the one thing that I can be proud of and now its as if theyre fading. I’ve been undermotivated as if nothing matters because no matter what after I die, within years I will no longer be even a memory. I always have a sense of isolation, wherever I go. If whats wrong with me isn’t schizophrenia, then what is it and how can I fix it.

You are in obvious pain. That is exactly why you should seek treatment. It could help you to feel better.

You asked whether or not you have schizophrenia. I cannot determine a diagnosis online. That is another reason why it is important to see a mental health professional. He or she can determine if you meet the criteria for any mental health disorders.

In addition, I need more detailed information from you. For instance, you mentioned that you have tried medications without results. Are you referring to psychiatric medications? Are you seeing a psychiatrist? A family doctor? More information about what you meant by the expression “have tried [to] add medications” would have helped me to help you.

You also mentioned that you act out violently. It would’ve been helpful to have an example of what you consider “acting out violently.”

Generally speaking, schizophrenia is a relatively rare disorder. It is even more rare among individuals under the age of 18. Don’t assume the worst case scenario. You may be experiencing an adjustment period in your life. Depression might also be a possibility.

The teenage years can be volatile. Individuals are beginning to explore who they are. It can be and often is a confusing and tumultuous time in an individual’s life. P. J. Ekerrett of the Harvard Mental Health Letter recently described changes in the adolescent brain as being “colossal.” In all likelihood, those changes affect how one feels on a day-to-day basis. The neurological changes in the brain add to the already challenging time of being an adolescent.

Please speak to your parents about this problem. Ask them to have you evaluated by a mental health professional. Clicking on the find help tab, at the top this page, can help you and your parents locate a mental health professional in your community.

Dr. Kristina Randle
@DrKRandle

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Not Wanting To Get Better

by Kristina Randle, Ph.D., LCSW December 22nd, 2019
written by Kristina Randle, Ph.D., LCSW

I feel like that a lot of times. My therapist and doctor have asked if I want to feel better and I respond that I’m not used to feeling good and it’s a strange feeling. I was told my depression started in my childhood and it’s hard to stop thinking about that. My comfort zone is when I feel depressed because evidently I’ve been depressed for so long before ever seeing a doctor and if I were to feel better and be happy, I’d feel like a different person. Feels like depression is so comfortable, I don’t want to give it up. I also feel weird because, in my thinking, if I feel better, I won’t have to go to the doctor and therapists office as often because I feel that’s the one place that people seem to care. My psychiatrist’s office is not the only Dr. office this feeling comes around and eventually that feeling gets easier but it’s always there and I’m getting tired of feeling this way. I have others in my life who probably do care but either I can’t see it or I just don’t know what it is. I’d like to know why I feel like this and how I get past this type of thinking. One thing that I’m really afraid of is that the therapist and doctor will think I have feelings towards them and I don’t, I just feel they care about me more than anyone else has. I worry they’ll suggest I see another Dr. and therapist, which I won’t. In that case, I’ll see my PCP and wean off medicine and take life as it comes then. I’m already a nervous wreck about talking about this with my therapist from the exact office that I get these feelings. At least I don’t see the Dr. for a few more weeks. I don’t know whether to talk to therapist about it since I can’t seem to change that way of thinking on my own, or just keep this all to myself, because really I have no idea how I could ever start talking about this. I have an appointment already made but can’t decide if I should try to let things go on my own and cancel the appointment or not and probably just prolong the agony. Do you think this is something I need to talk about with my therapist or learn to deal with it on my own, kinda like I have all along.

It would be wrong not to reveal this information to your therapist and to your doctor. It is important that they are fully aware of what you are thinking and feeling. They can’t help you if they are unaware of your concerns. In fact, revealing such information could lead to psychological growth, which is the goal of therapy. Giving in to your fears might strengthen the depression. You want to avoid that.

You may gain “comfort” from depression because, as you have said, it has been with you since childhood. In that way, it might function as an emotional security blanket. Not feeling depressed means that you will have to feel something different. It is natural to fear the unknown. It is human nature.

While the depression may comfort you, it’s important to understand that it only holds you back in life. It is a false sense of comfort. Depression is nothing that you should want to hold onto. My advice would be to force yourself to be honest with your treatment providers even if that prospect frightens you. Therapy is often not a comfortable process. Deciding against revealing your true thoughts would be like giving yourself permission to continue living with depression. The results of such a decision would mean prolonged suffering. Go to the appointment, be honest and begin the process of eliminating depression from your life. Please take care.


Dr. Kristina Randle
@DrKRandle

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Depressed?

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP January 3rd, 2020
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I think I may be getting depressed. Since my divorce five years ago I have been single with only a couple of casual encounters. My ex was alcoholic and mentally very abusive (not physical) also my childhood was quite abusive with a violent father and a mother (both of whom have died) who was depressed (due to the violence.) Also I have a physical condition called brittle bones, which resulted in me having many broken bones as a child and missing years of schooling. After university and having largely overcome my physical condition I went overseas traveling (in part to test myself and in part to get away from family.) I ended up in the US and married the first person that seemed to care and love me. When I did finally leave my husband after trying to make the relationship work longer than I should I was at breaking point mentally – life held no joy, I was in a low paid menial job and felt that I lacked ability to find something better, that I had no friends and that I was utterly unlovable (my mother told me as a child that she feared no one would love me.) I decided to take a year out and look after myself I went into counseling which was a rewarding and healing experience if very confronting and at time harrowing. I realized that I did have friends who cared for me and as the healing process continued I made many more and feel truly blessed to have these people in my life. My job situation did not improve and after being turned down for another promotion I decided to take time out have a think and see a bit of the world, I spent some months traveling which was mostly wonderful. I returned to the US for the best part of a year and found work with a large company who valued me. I came to realize that as much as I loved my friends in the US I did not have a family and no relationship (and no real hope of one.) I decided to move nearer to my siblings (all in the UK), as with both our parents gone we are all we have. Not wanting to live in the UK I relocated to Germany where I had some friends and as a means of earning money trained as an ESL teacher. Teaching has been a revelation – I never expected to enjoy it but I find it so very rewarding and am motivated to make a go of it and have a two year plan for experience and training (the first time in my life I’ve had such a thing.) My problem is I feel overwhelmingly lonely, when I arrived a friend (who I had feelings for) confessed that he had feelings for me and we began a relationship after two weeks he told me that he changed his mind and didn’t want to continue (but never told me why.) I cannot get rid of the feelings of rejection and that I am doomed never to be or even experience a loving nurturing relationship and that there must be something wrong with me. Despite relocating my relationship with my siblings is almost non-existent – they have made no effort to visit me or reply to my emails. My two sisters are not on speaking terms which meant when I did visit them I had to choose who to see and when, as ever I made the wrong decision and no one sister is not talking to me and the other if she does contact me talks mainly about what is wrong with the other. My brother is the only one of my siblings who even asked about my time in Germany. I feel so lonely and unloved that I often cry (I never realized how much a person can cry.) I have made some other lovely friends since my arrival but as ever they have their own relationships and, well Saturday’s nights and weekends generally are just lonely. I do enjoy the delights of my new home – the museums, art and beauty but it’s always alone. I am at the point where I cannot bear to see people in love (which you see a lot of in Europe!), as it is just a reminder that no one loves me. I know a relocation such as I have undertaken would involve periods of loneliness but I am worried that I may be falling into something more. I don’t seem capable of taking joy in my achievements – relocation, finding a job so fast, finding a beautiful apartment etc. At present I feel as if I could disappear and no one would notice. I am unable to seek counseling here as at present I am only on a part time wage so would welcome any advice you could give me. I apologies as I fear I have taken more than the 400 guide.

Kind regards.

Give yourself some well-earned credit. There are two primary forces that motivate us in our lives: moving away from pain, and moving toward well-being. You have been able to move away from what was unhealthy. This is a major and essential ingredient in being able to move toward what you want.

In the past counseling was helpful, and I suspect it will be helpful again. You may want to look for both an individual and group therapist. The advantage of adding group therapy is that you will be able to get feedback and learn from many others in the group.

You have proven to yourself that you can flourish when the right conditions are present. The work now is for you to find the right conditions for your growth. Making new friends, engaging in the process of therapy, and finding a creative outlet will be important ways for you to grow.

Wishing you patience and peace,
Dr. Dan

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What is wrong with me?

by Dr. Marie Hartwell-Walker June 20th, 2019
written by Dr. Marie Hartwell-Walker

Its been years since i really enjoyed..well anything. I can sit down and like doing something, tv, books, chores, walking the dog, or just going for a run. I am capable of getting up and doing it all. I do what needs to be done. I have never really had a favorite color, or favorite TV show or even a favorite thing to do. I like everything yet I like nothing. I feel indifferent about everything i do. To include work and everyday chores. I do it because i know i have to and because i have kids that are depending on me or it is my responsibility. I find myself crying over everything. I cried when i read some of the other posts because they explain some of the feelings i have that i can’t seem to explain. I cried over my kids eating breakfast and i am starting to cry over this because i feel stupid for not knowing why i constantly feel ‘not normal”. Lately i feel like i am making it all up in my head. Its like i so desperately want some one to give me an answer for everything that I am making it all up. That there is really nothing wrong with me and everyone feels like this.

Now to come full circle. With all of this inadequacy that i feel at work i wonder if its the job. I have looked at other work. But because nothing really makes me happy would leaving really benefit me. I have never known what i wanted to do and i know i could make plenty of money staying where i am being miserable or i quit and face the same problems in another career field. I am so afraid of disappointing the people at work by quitting that i would rather have been in a total wreck to where i couldn’t go any more. My memory has been failing me lately, to a point my husband wants me to be check out; I would rather have a brain tumor than face my boss and have him hold a grudge for me not being able to handle all of this (more tears).

I feel almost like the things that happened with my ex caused me to start this downward spiral. I want an answer to what is wrong but fear the answer. HELP!

I didn’t include all of your long letter because the most important part of it involves your feelings. It sounds to me like you may have been suffering from dysthymia for some time. Dysthymia is a mood disorder where the individual is chronically depressed but at a lower intensity than in a full blown depression. As you report, it can go on for years and it can make life feel endlessly gray. I don’t know if your negative experiences with the former boyfriend are at the root of it. It may be that you would feel this way even if you’d never met him. He gave you reason to be angry and sad but it’s possible he only worsened an ongoing condition. As far as the job: It’s just true that wherever you go, there you will be. Changing the job won’t change your mood. Changing location won’t either. If the man you are with is a good guy, leaving the relationship also isn’t likely to help.

Instead, you need to see a mental health counselor. Bring your letter with you. You wrote an eloquent description of what you’ve experienced and felt. Your counselor will be able to hear more details and will be able to make a more sophisticated assessment. The two of you will then discuss treatment options. Some medication may be helpful to lift your mood a little so you will have the energy and interest to take better care of yourself and to take better care of your family. Some therapy will give you both some much-needed support and some practical ways to manage your gray moods.

You made an important first step in writing. Please follow through and get the help you need.

I wish you well.
Dr. Marie

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Mother is negative about everything and alienating the family

by Dr. Marie Hartwell-Walker July 24th, 2019
written by Dr. Marie Hartwell-Walker

I am writing you because I do not know what else to do. I am a 26 year old female who recently left her home and family to make a family of her own. My father and brother both commited suicide, my father when I was 10 and my brother when I was 24. I have a sister who is my best friend but my mother is the issue. My mother was always very compassionate, empathetic and loving but after her divorce from her second marriage, she cares about nothing. She is disabled and has very little money, no job, no partner and suffers from depression. I am getting married next month and had mentioned that I would like to celebrate my marriage with just my fiancee and myself. My mother was very upset with me and refused to talk to me for 3 days. My fiancee and myself then planned a small wedding including 30 guests, fancy wedding and a reception. As the wedding came closer I couldn’t help but feel overwhelmed and the realization that my father and brother would not be there was heavy on my heart. I began crying everyday thinking about my wedding and how its simplicty was lost in stupid things like what color the napkins should be and how large the cake should be. I know that deep down I really just wanted to have a wedding completely focused on my marriage vows and really focus on the love that my fiancee and I share. I finally got the courage to ask my mother for her advise and help with being so upset. She laughed at me and told me I was just like my father (who never liked to be the center or attention and I am indeed like him in that way) and that I needed to suck it up and shut up about it. I told her that the reason I was miserable was because I had planned my entire wedding putting her first by including everyone and making it like every other American wedding and did not listen to my heart. She laughed at me when I told her this and says she doesnt even remember being upset about it and genuine said she really doesnt care. I want to tell my mother how much this hurts me and how she is alienating herself from her entire family but I am scared because she has mentioned suicide before and I feel that she does not have anything in her life that she feels is important or that she cares about. She is currently taking medication for depression and only has negative words to say when I speak with her. What should I do?

First, and most important: Congratulations on your marriage to a man you truly love. Please don’t let the wedding overshadow what’s really important. A wedding takes hours. A marriage should be for a lifetime. If the family wedding is something you’re doing for others, I do suggest that you and your fiance also have your own private ceremony that is just for you where you can focus on your love and your vows. You can go to a justice of the peace or the two of you can simply go to some beautiful spot and repeat your vows to each other.

I’m so, so sorry about your losses which now number three: Your father, your brother, and your mother. You’ve “lost” your mother, at least for now, to her depression. Please don’t listen to her words. The things she said about your wedding are the depression talking. Like you, she has lost two people she loved. Unlike you, she hasn’t found a way to move forward. My guess is that the laughter isn’t about ridicule or amusement. It’s a cover for anxiety and pain. I’m very concerned that she has talked about suicide. If you can, see if you can go with her to talk to whoever is prescribing for her. The prescriber needs to know how serious her symptoms are. She may not be as forthcoming as she could be. Further, she needs more than medication. She needs a therapist to provide additional support and guidance during this difficult time.

It’s just true that sometimes when people need help the most, they push it away. It may be helpful to organize some of your closest relatives to support your mom. Make an appointment for a consultation with a mental health professional to help you all understand effective ways to help her. I can’t guarentee it will work but I think you’ll feel better if you know you’ve tried everything possible.

Please remember that you carry your father and brother with you in your heart. It’s tragic that the only way they could figure out to end their pain was to suicide. Like your mother, they were too caught in their own feelings to think about how their actions might affect you and the others who loved them. To me, that means that their pain was very big, not that their love for you was too small. I hope you can focus on positive memories and celebrate that your father lives on in the ways you are like him.

I wish you and your family well.
Dr. Marie

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Anger About a Terrible Life

by Kristina Randle, Ph.D., LCSW February 15th, 2019
written by Kristina Randle, Ph.D., LCSW

I was Adopted at Birth, my step mom died at 9 and my step father drank himself to death when I was 13, I lived on the street for 7 months as a runaway from a foster care center in Chicago working 8 hours a day on newspaper trucks being paid $3.00 a day by the drivers, was arrested placed in a juvenile detention facility and then as a ward of the State of Illinois they had me committed to the Chicago State Hospital where I spent 4 months on the Mens Recieving unit at age 14 before being transferred to a to an adolescent unit CW 10, left the State Hospital at 16 hitch hiked around the country for two years staying at missions and working day labor joined the military where I served on Submarines, got out got Married had 3 children got divorced when they were little, I am now 57 years old with an 8th grade education and am home bound with congestive heart failure and emphysema, My twins just returned from Afghanistan all 3 of my kids are in the Army, my whole life seems to be replaying itself in my mind, and it does not make any sense it just seems so unbeliveable that anyone would have to go thru what I went thru, I am a very strong person but I need to come to terms with this, because thinking about it makes me angry !

Nothing can change the past. It will always be a part of your life. It is important to view your current life in a realistic perspective. Famous psychologist Abraham Maslow says that “getting used to our blessings is one of the most important non-evil generators of human evil, tragedy and suffering.”

You have suffered a great deal in your life but there are blessings that you are undervaluing. There is an old saying that may be instructive: “I cried because I had no shoes, until I met a man who had no feet.” You mentioned that you have twins who have recently returned home from Afghanistan. In fact, all three of your children are home and safe. Many families have loved ones fighting in Afghanistan, who may never see their children again. The fact that your children went to war and survived is a blessing that cannot be overlooked or underappreciated. The fact that you have three children is a blessing. Were you not blessed to have survived the ugly, bitter events of your childhood?

Dwelling on the past might lead you to feel anger. Your anger is understandable but it is self-destructive. You were dealt a difficult hand in life but you have survived.

Counseling could be of great help at this time in your life. What has happened in your life can never be changed, but how you view it and respond to it certainly can be. Counseling can help you to accomplish both. I wish you the best of luck.

Dr. Kristina Randle

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I started unhealthy ways to deal with stress

by Dr. Marie Hartwell-Walker September 8th, 2019
written by Dr. Marie Hartwell-Walker

Hi, I`m 17, I have started finding a unhealthy way to deal with stress, depression, and loss of my dog too well. I didn`t know how much stress my beloved dog helped me with for soo long till he died this year. When I went to school this one day I got told that I was stupid and pathetic because I didn`t take a phone away in one of the classes I was teaching. I know I don`t have the right to do that but I wasn`t feeling good, I had just lost the dog and the teacher had to take it out on someone about the fight he got into the day before and he took it out on me. That night I went home and used a saftey pin on my wrist.
My mom doesn`t get it I have been regected by my real dad and my step and this is my final year and I have to find money to go to college and she doesn`t know that I don`t sleep my eating is down I do eat somedays but I can go a few days to a week without eating but I can always make it look like I`m eating just so that she doesn`t get on my back. I think that every thing is my fault since I`ve been told since I was little that everything is my fault my grandpa`s death that was my fault, and the dogs death also my fault. My mom is sick so my step dad blames me for that and it puts sooo much stress on my I get really sick to my stomach and don`t eat or sleep. I thought things would get better they just stayed the same I get thoughts about killing my self and tried but never went threw with it I chickened out because I can`t do what my one friend did to her friends and her parents and little sister. I feel like I`m alone I`ve tried to make my parents happy but they just seem to not really care about me. I feel like I`m a no body to them cause my step dad told his friend in front of me shes not my daughter and I feel like I just don`t belong in this world.
I need help!!! I don`t want to feel like this anymore!!!

Not every kid gets the family she deserves. Sadly, you are one of many, many people who were born to a family that doesn’t give her the emotional, psychologicial, and practical support she needs. The fact that you have grown to be the sensitive, articulate person you are in spite of it tells me that you have more inner strength and gifts than maybe you can even appreciate right now. Your sadness and distress are too much in the front. You’ve been told so often that things beyond your control are your fault that you’ve started to believe it. You are not at fault for people being sick and dying. It sounds to me that people who can’t cope with their own grief and responsibilities are shifting blame and shame to you.

In the States, there is a public service advertising campaign going on called “It gets better.” Celebrities and politicians are speaking out about how they were bullied for various reasons and how it got better once they got older. The message to people like you is, “Hold on. There’s hope. You’ll grow up and grow away from your current situation. It gets better.” It does. College isn’t high school. The adult world isn’t either. Once out of your family, you can make the kind of family you want.

So hold on! Depriving yourself of food won’t help you. You need your strength. Not sleeping won’t help you. You need your rest. Hurting yourself won’t help you get to a better place either. Instead, turn that self-destructive energy into motivation to get out of there. Go see your guidance counselor. Look for scholarships and grants that will get you to school in a year. Get a part-time job if you can and start saving your money. If your resume is weak, get yourself into some extra-curricular activities that will make you attractive to schools. Grades not good enough? Look for a “gap year” experience away from home. There are exciting, and subsidized, service opportunities out there. You’ll get a year away from your hometown and some money to help pay for school. Colleges look favorably on someone who has done a gap year as well.

I’m glad you’ve ruled out suicide as an answer. Saying “yes” to life is the first step. Now gather your resolve to take charge of your life to make it better. You can do it. You’ve managed to survive this long. Now it’s time to do better than surviving. With some effort on your part, you can be in an entirely different place next year. You can make a new start and a new life. You’re almost there. You can make it better.

I wish you well.
Dr. Marie

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Black Sheep of the Family

by Kristina Randle, Ph.D., LCSW August 17th, 2019
written by Kristina Randle, Ph.D., LCSW

Not that it really matters but I am starting to feel like a outcast in my family and I am the eldest child out of my other siblings. I feel that my parents have picked out their favorites and have sorta left me to the slaughter. I come from a good family and I am a good person have really done no wrong to no one just typical things that people do in life.

I don’t go around my family as much as I use to I can count on one hand how many times I visited my parents this year alone and we do reside in the same state. I do feel bad about this at times however I’ve come to realize that less time with family means less pain for me. I hate how I’m treated!!! I am just a no one to them, my mother calls me sometimes but not the way she calls my sisters, its like she has to force herself to call me. I am a good person!! Why cant they love me like they love and treat my other siblings? I just want to fit in I want to feel right. Will I always feel like the black sheep or be treated as such because I am not as bright/smart as the others?

I am currently on zoloft generic brand but I don’t feel its working I’m thinking of getting on the brand name zoloft because the generic brand may not be working for me. Is there a difference?

It is unfortunate that your family treats you badly but there may be little that you can do to change this. It might be best to continue to limit your interaction with them.

If I had the opportunity to interview you, I would want to know if you ever discussed your feelings with your family. If not, one option might be to tell them how you feel. They may not be aware of how you feel. Perhaps bringing it to their attention might help. If you don’t feel comfortable having an in-person discussion with them, consider writing them a detailed letter.

An important part of human development is becoming your own person. For some people, this can mean estrangement from their families. That can be an undesirable path but in some cases it is necessary for healthy psychological development.

It is important that you do not misinterpret the meaning behind your family’s actions toward you. In other words, the way they treat you is not a reflection of you. Rather, it is a reflection of them and the psychological problems that they may have. Their unresolved psychological problems might prohibit them from fully appreciating you or may limit their ability to express their feelings.

With regard to your medication, there could be a difference between the generic version of Zoloft and the name brand. Consult your doctor for further details. Switching medications might improve your symptoms.

If you continue to struggle with this problem, I would highly recommend consulting a therapist. A therapist could assist you in facilitating a discussion with your family. A therapist could also help you to navigate your family situation. Take care.

Dr. Kristina Randle

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Life Not Going Well And Considering Suicide

by Kristina Randle, Ph.D., LCSW April 6th, 2019
written by Kristina Randle, Ph.D., LCSW

I am writing you because I recently received some sessions at a local community therapy clinic and I don’t feel like we accomplished anything there. I am constantly thinking about suicide, or (I’m ashamed to say) faking a suicide so that I can get help. I was fired from my job about 2 months ago and haven’t been able to get another one. I recently started college and I am having to appeal a financial aid denial due to missing dropping the one class I registered for when I was 17. I have no family to look to for financial support and my situation gets more and more desperate every day.

If all is trying to look for a job and go to school while sleeping on the streets with no help or support from anyone I know, what really is the point of going on? I wonder, how is an able bodied, 25 year old male, with no family, supposed to get any support in this world?

It is good that you have begun your therapy at your community mental health agency but you think it may not be helping. Talk to your therapist and be honest about the fact that you feel your work together is not effective. In many clinics, it is relatively common for clients to try several therapists before they find a suitable match.

In addition to individual therapy, you should also consider group therapy. Some individuals prefer group therapy over individual therapy. There are several advantages of group therapy, including: increased support, increased feedback, increased interactional opportunities, and the chance to practice and to develop social skills. The more people that you can make a positive connection with, the better you will feel. Group therapy is also generally less expensive when compared to individual therapy.

You may also want to investigate the counseling services offered by your college. Most colleges provide their students with short-term, professional mental health care free of charge.

If you were to get a job or were granted the necessary financial aid to continue college, I believe that your mindset would change. It is important to keep your situation in perspective. It is a difficult time in your life but that can change. There are many ups and downs in life. That is true for everyone.

Your lack of social support is also contributing to the problem. If you had more support from friends or from family, then you would be less likely to consider suicide. That is one reason why it is imperative for you to stay connected to a mental health agency, and you can do this by joining a support group or by finding a different therapist.

Individuals who are considering suicide often view their life situation through a prism of hopelessness. Their difficult situation is temporary but they don’t see it that way. They have difficulty envisioning an end to their suffering. Understandably they want their pain to end. Getting help is the answer, not suicide.

I would recommend that you read this article about individuals who attempted suicide and survived. One of the most important messages of the article is that the individuals who attempted suicide and survived were thankful to have lived. In the depths of depression, they incorrectly predicted that their lives would never improve. They were fortunate enough to live to see their lives improve.

Don’t stop trying to get help. Try other therapists. Investigate other types of treatment such as group therapy or psychiatric medication. Remember that even though your life is difficult now it can change. Call 911 or go to the emergency room if you feel that you cannot keep yourself safe. I wish you the best. Take care.

Dr. Kristina Randle

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What Is Partial Hospitalization?

by Kristina Randle, Ph.D., LCSW February 8th, 2019
written by Kristina Randle, Ph.D., LCSW

How do I know if it’s really necessary? I have Bipolar II and am on a mood stabilizer (Trileptal) and a small dose of an antidepressant (Lexapro.) I’ve been having a very rough time with depressive symptoms over the last few months – it started with just not being interested in anything, sleeping a lot, and eating a lot, and got up to crying at the slightest provocation and bouts of leaden paralysis.

At my most recent psychiatric appointment, I asked for an increase in my Lexapro dose, because it makes the most sense to me (I’ve been on doses up to 2.5 times what I was on at the moment, with no clear manic symptoms.) But my psychiatrist asked instead if I’d be willing to enroll in a partial hospitalization program.

We’re going to talk more about it at my next appointment, because we ran out of time. But I’ve been looking online at partial hospitalization programs in my area, and I’m confused. What are they, really? They sound like they’re just classes – not focused on adjusting my drug regimen so it’s perfect, but rather on the “coping with life” stuff that is basically impossible for me when I’m in the middle of an improperly medicated depressive episode. And how bad off do you have to be before they’ll let you in one of these programs? Yes, I need help, but do I really need that much help?

I’m also quite alarmed and sort of offended by the “you can’t have your phone and we take your shoelaces” stuff. I’m not psychotic or suicidal. Why on earth would they want to isolate me more, and make me feel more crazy than I already do?

Partial hospitalization refers to a comprehensive, short-term, intensive, clinical treatment program. With regard to level of treatment, partial hospitalization is a step below inpatient hospitalization but more concentrated than traditional outpatient care. Clients are generally referred to partial programs when they are experiencing acute psychiatric symptoms that are difficult to manage but that do not require 24-hour care.

Individuals in partial hospitalization programs attend structured programming throughout the day, three to five days a week and return home in the evenings. To ensure client safety, many of the inpatient hospitalization rules apply (i.e. no phones, no shoelaces) to partial hospitalization programs.

There are many advantages to participating in a partial hospitalization program. You are worried that the program may isolate you but the opposite would be true. Many partial programs provide group therapy which would allow you to interact with other people experiencing similar problems. You would also have the opportunity to interact with psychiatrists, social workers, nurses, and other mental health practitioners. The goal of many partial hospital programs is the development of skills that help clients better manage their lives and their symptoms.

Consider attending the program. Your doctor thinks it is necessary. I have worked with many clients that had expressed similar concerns about partial programs but who were later glad they attended. Remember that the program is short-term. It has the potential to help you tremendously.

At your next appointment, I would recommend discussing your concerns with your doctor. He or she may provide more information about the program which could give you a better understanding of what to expect. I wish you well. Please take care.

Dr. Kristina Randle

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I Need Help

by Kristina Randle, Ph.D., LCSW November 2nd, 2019
written by Kristina Randle, Ph.D., LCSW

Hi ~ I’m 13 years old & I’m chilean so I’m sorry about my English. So, I just feel a total looser, I’m freaking fat (Usually people say I’m skinny, but I’m pretty fat) & my emotions are like a roller coaster. I cut myself since I’m 11 & I’ve tried to stop but I just can’t. When my mother yells at me I just feel like a piece of trash & I just NEED to cut myself. Cutting is my drug, I’m obsessed with cutting. Honestly, I started cutting myself because I was bored but it became very serious: now I have suicidal thoughts. I just don’t know what to do anymore, I can’t concentrate in class. I’m tired of faking smiles s o people can’t realize about what’s going on with me. I don’t want anyone to know about what I’m going thru cause they would think I have psychologic issues & anyone would ever talk to me again. One of my best friends saw my cuts & said I was crazy for doing that & that I needed to get help, so that’s what I’m doing.

I have a crush on my best friend & we are both girls.

We’ve been friends for a year but I never felt like this with any other of my best friends. We sometimes ‘flirt’ with each other and stuff but I think for her it’s just joking around. I like her but I also like guys.. Am I bisexual? Thank you.

Cutting is unfortunately prevalent among young adults. Many people engage in cutting or in other self-harm behavior because they lack the necessary coping skills that would assist them with difficult life problems and emotions. I believe that this is likely the case in your situation.

You asked whether you are bisexual. That is a complicated question. Some individuals report experiencing a time in their lives in which they are attracted to both males and females but later find that they are only attracted to one or the other. In addition, the fact that you are currently experiencing psychological problems makes determining your sexuality a difficult question to answer. You may have a clearer understanding of your sexuality after you become more emotionally stabilized.

My concern is that in addition to cutting you have suicidal thoughts. Suicidal thoughts are very serious. My recommendation for you is to speak to your parents. You need to let them know that you are struggling. It is also important to inform them about your cutting. If your parents knew about your difficulties, they in all likelihood would seek professional help for you.

You mentioned that you are ashamed of your problems but please don’t be. None of these problems are your fault. Not disclosing your problems means that you will continue to suffer. Many people experience psychological problems. They seek help and they receive the help that they need and want. Please inform your parents immediately and call emergency services or go to the hospital if you feel that you might harm yourself. I wish you the best of luck. Please take care.

Dr. Kristina Randle

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Urge For Suicide And Suicidal Images And Thoughts

by Kristina Randle, Ph.D., LCSW November 6th, 2019
written by Kristina Randle, Ph.D., LCSW

I I am from Korea, Seoul and I have been on medication for my psychological reasons. I tried to suicide less than twice and I have been always the one who has a lot of suicidal tendencies. However, my only brother did it last year. Sometimes when I think about past with him, I can’t help myself from the urge to kill myself. Even now, the only reason I am alive is because of rest of my family. my sister and mom saw him and I saw only pictures from detective office. It looked painful and I can’t forget his purple fists.

I gotta live only for my family because I don’t want to give the pain as we got from my brother. I got diagnosed to have Bipolar I, depression, ADHD, anxiety disorder. and recently I think I might have border line of schizophrenia due to my thought, images, and also the way how I understand whatever other people say.

I really need your help so that I can be alive for my rest of family. is there any way for you to give me any advice?

I am sorry for the loss of your brother. I can imagine how difficult this time in your life has been for you. The fact that you have attempted suicide, are currently considering it and have a family history of suicide, is concerning. Those variables put you at risk for suicide.

You stated that you are taking medication for psychological reasons but you did not mention counseling. Medication alone is often not enough to treat psychological problems. Counseling is an important aspect of treatment. Counseling could also greatly assist you in appropriately grieving the loss of your brother.

Studies of suicide survivors have shown that the decision to end their lives was not well-planned. Those decisions were often made impulsively. If you feel that you might harm yourself, it is imperative that you go to a hospital. The hospital can protect you from making an impulsive decision.

Suicide survivor research also has shown that the majority of individuals who had survived their suicide attempt, never truly wanted to die. They were thankful to have survived. Those individuals were suffering and they often lacked the necessary coping skills to deal with difficult life situations. I believe, at least in part, this is the case with you.

It is important that you talk to your parents about getting into counseling. You should also consider joining a suicide survivors support group. Go by yourself, attend group meetings with your family or do both. Survivor groups can be tremendously helpful. Here is a link to a website where you can find a list of support groups in your community. Here is an additional link to a resource page where you can find related websites.

It is imperative that you speak to your parents or to your prescribing physician about your suicidal thoughts. If you feel that you can’t protect yourself, then you must go to the hospital or call 911. The phone number to the suicide helpline is 800-273-8255. Do not hesitate to call if you are feeling overwhelmed.

Help is available. Please be willing to accept it. If not for yourself, do it in honor of your brother and for the sake of your family who would be immensely devastated by the loss of another beloved family member. Please take care.

Dr. Kristina Randle

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For the past 10 years I have felt unhappy

by Dr. Marie Hartwell-Walker September 28th, 2019
written by Dr. Marie Hartwell-Walker

Hi
Im 27 and for the past 10 years i have felt unhappy and hopeless.
I think this started when i was 13 and has gradually got worse and worse over the years. Im at that age now where ive thought about the way that i feel and want to do something about it instead of just trying to shut it out.I want to be happy, i want to love life and i want to engage in it and feel good about that and for the past 4 years ive been trying by buying self help books and going on courses, seeing a counsellor, cbt therapist. Nothing works an im really scared that the way i feel wont change and no one can help me.

I also want a boyfriend but with the way that i feel im not much use and just dont feel like i can cope with it. My self esteem and confidence are LOW especially when it comes to men and relationships. I used to want children but now i really feel its wrong because what if they feel like i do? what if they cant get out of it like me?

Ive been the doctors and im going to see a psychotherapist but im really scared that they wont be able to help and then were were do i go from there? ive even tried spiritual practices but again nothing. I never im a million years thought that i would feel like this for this long and this would be my life when i was growing up but it is and i cant escape it. I often get really freaked out by all this and feel histerical.

None of my family or friends know how i feel and when ive tried to explain they just dont get it. Im also in my second week of seeing a life coach but im thinking that its not enough and reinforces my hopelessness. I dont know what to do what if it never changes!?

Thank you for taking the time to read this.
and sorry for the lack of paragraphs.

I’m so very, very sorry that life has been so difficult for you for so long. Although I can’t make a diagnosis on the basis of a letter, what you report is consistent with a major recurrent depression. It sounds like you’ve done all the non-invasive, non-medical things one can do. Give yourself credit for how hard you’ve worked at this.

If you haven’t already, please see a medical doctor and get a thorough physical exam. There are a number of medical conditions that can cause or contribute to symptoms like yours. We want to be sure that there isn’t an undiagnosed medical condition. If everything looks fine medically, the next step is to see a psychiatrist. (Perhaps you’ve done this already but you didn’t mention it.) Psychotropic medication may help jumpstart you enough out of the depression that you’ll be better able to make good use of your therapy.

If medication fails, there is ECT (electroconvulsive therapy), once called electroshock treatment. Although a treatment of last resort, it is often effective in treating a prolonged depression like yours. During ECT, light seizures are induced while you are under anesthesia. It isn’t clear just why it works but it is regarded as both safe and effective. Like medication, there is a chance of side effects. You and your doctor would discuss whether the chance of those side effects is outweighed by how miserable you’ve been feeling.

I encourage you to educate yourself about available medications and ECT and to discuss these options with your psychiatrist. There are still some treatment options you haven’t explored. I hope one of them gives you the relief you deserve.

I wish you well.
Dr. Marie

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Wife Has Unfounded Fear And Wide Mood Swings

by Kristina Randle, Ph.D., LCSW April 21st, 2019
written by Kristina Randle, Ph.D., LCSW

I

have 34-year old wife and 2 kids (daughter 9 year old and son 5 year old). I love my wife and kids.

I’m married for almost 11 years now. Although, I’ve seen my wife’s mood swings immediately after marriage, thought that would fade away after few more years. And, that too I was travelling and staying in USA, Japan, India, because of these frequent change in residence – for the first 5-6 years, didn’t really think she had a big problem in these mood swings.

But, then when we decided to settle down in Bangalore in 2005, things started changing after 2006 (May) after my son was born. Of late, its become unbearable and she has initiated divorce and want to take away the kids. My daughter is so attached to me, but my wife is adamant in taking her also along with her. In India, the divorce law works different for different religion and me being a Hindu, in most probability both the kids would go to her.

Leaving aside the legality, I’m determined to find a solution to my wife’s problems. I’ve read about Schizophrenia and Bi-Polar, but not able to decide to what category my wife falls into. Here are few things, which I can tell about her anxieties, etc:

1) MAIN THINGS RELATED TO HER BEHAVIOUR:
===================================
Main thing that can be highlighted – her sexual aversion (dislike). All her thinkings and imaginations were revolving around that:
a)Her accusations for 5 years that I’ve some extra-martial relations (which has no truth)
b)Her accusations always related to sexual stuff – something like sister-brother sexual relationship; sexual relationship with immediate family members
c)She even told my daughter 2 days back in her screaming voice that even after divorce we all won’t let them live peacefully and I would push my daughter to prostitution
d)Someone called her lesbian. In fact, just 2 days back before she being called a lesbian, she told that, she had told her sister what lesbian means and immediately she got this idea that someone called her lesbian. In fact, I was witness to some call her friend made talking for almost an hour about some vulgar stuff
e)About a year ago, a spiritual leader she trusted misbehaved with her. Her sisters say that this might be a lie.

Was there any sexual assault which she had early in her childhood, which is not known to anyone, because of which she starts thinking negative on this?

2)Her wild imaginations – mostly compounded by unfounded fear. Some examples:
a)The swimming pool where she used to take my daughter for 3-4 years; she thought her sister is telling some confidential information to some people who used to come to the pool. She suspected me also that I used to supply information. She had altercations there always with almost everyone
b)When we went to North India trip last year, she was constantly telling me that, her sisters were calling up the driver and was inquiring about her – the dress she was wearing (was it tight or not.. etc..)
c)The music class where she took my daughter – she had more severe problem that my friend’s wife told something to the music tutor and everyone there out was trying to harm her and my daughter. She insisted me to go and check with the tutor. I with lot of reluctance asked the tutor- she told that its all her imaginations. Even my friend’s wife came and told the same thing.
d)She told me that she observed me talking to some call-girl in the night time (this argument went on for years again). We all used to sleep in the same room, but still my wife contents that I was speaking
e)She accused me again that I used to discuss the sexual problems with her sisters (Oh man.. this was too much of imagination)
f)I had given my cell phone to her for 3 months; she didn’t find any such calls and later told that I used to call from my office; I told that I can bring a printout of what calls I made or received; she then told that I used a public booth
g)Pestering my daughter that someone called to her school telling something. Her school does not encourage that
h)She has told many times that her phone is being tapped
I or sister or someone has sent someone to spy on her

3) Socialization problems:

a)She had big socialization problem; never used to mix with anyone or trust anyone. Sometimes she used trust someone and later used to tell they are bitches. Used to quarrel with most of the people. I had to change the residence; the situation became even worse and we almost had street fight on a daily basis with neighbors and had to go the residents association. Later got an anonymous letter from someone (we suspect it was the neighbor) addressed to me telling all about her extra-marital affairs with someone she used to roam around when I was in office. I didn’t go to verify and just ignored it. I supported her in her fight against this letter. This letter is very nasty. If it was true, then its very ugly
b)I had told many times not to go to pool or classes or anywhere, because, she used to fight with almost everyone. She then used to tell me that I was discouraging my daughter.
She surely has a perception problem and gives opinion for others – something like I don’t care for the kids. Her expression of love and affection is something she accepted as standard.

4) Incidents which might have influenced her behavior:

a)Losing both the parents in teen and she herself claims that she was the favorite kid for both of them
Searching for father-like figure even with husband?
5-months after marriage she had to come back from USA and stay alone being pregnant in sister’s house. I had traveled back to USA
b)Mother-in-law’s (my mom) insistence of staying with us and her (my mom) suicide within 15 days after 2nd child’s birth
c)Father-in-law (my dad) moving to our house and his constant pressure (my wife was also part of it)

She has a big suicidal tendency. She has tried to commit suicide many times. Even 2 days back, she was trying to. This time it is more dangerous, where she want to take the kids also along with her. Looks like she’s suffocated with something mentally.

She refuses to visit a doctor and thinks that she has no issues at all. I’ve contacted many counselors – they all accept this, but say that she has to go there.

Do you see any problems with my wife? Based on the descriptions, what is the ailment which she has? Depression or Mania or Schizophrenia?

Despite the many details you have provided, I am unable to give a diagnosis over the Internet. Having said that, I can make suggestions for how to approach this problem.

The three biggest concerns about this situation are: (1) that your wife has a history of suicide attempts; (2) she is currently considering suicide again; and (3) she has threatened to kill your children. Those are major red flags. Take her threats seriously. Your wife is not thinking clearly. She is paranoid and delusional. I am not familiar with the mental health laws in India. Nor am I familiar with your country’s legal system but it is important that you consult with both legal and mental health professionals. They can help you to determine what legal options you have and how to protect your children. The children should not be in your wife’s sole care. They would likely be in danger.

You stated that you have contacted many counselors. Have you informed them about her suicidal threats, her suicidal history and her threats to kill the children? If not, then report that information immediately. In the United States, if an individual makes suicidal or homicidal threats, they could be forcibly hospitalized for their own protection and for the protection of others. Speak to the counselors again and ask them if similar commitment laws exist in your country. Forcing her into treatment against her will might be the only way to ensure that she receives the proper help and that your children are safe in her presence.

In addition, you stated that your wife has been pursuing a divorce and that in India, she would likely be granted full custody of the children. It is important that you inform the court about her suicidal history and her current homicidal threats against the children. The judge would likely not grant custody of the children to your wife if he or she was aware of her mental instability.

Accusations of extramarital affairs, convinced that people are spying on her and attempting to harm her, are all signs of paranoia and delusional thinking. Those symptoms are commonly associated with psychotic disorders, which may include schizophrenia, schizoaffective disorder, bipolar disorder, and several others.

If possible, surround yourself with friends, family and other supportive individuals. Your wife is unable to recognize that she needs help. Unfortunately, this puts you in a very difficult position of possibly having to force her into treatment. The reality is, however, that even despite her obvious need for help, the laws in your country might prevent you from getting her the treatment that she needs. Explore your legal options with the appropriate professionals. The Nodal Alliance Of Mental Illness of India may be able to assist you. Here is a link to their website.

If you have any additional questions, please do not hesitate to write again. I wish you and your family the best of luck.

Dr. Kristina Randle

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Am I Clinically Depressed?

by Kristina Randle, Ph.D., LCSW May 27th, 2019
written by Kristina Randle, Ph.D., LCSW

I’m always depressed when I’m not around my ex. because he’s the only one who really gets me and knows me and really listens when I talk. When he isn’t around I have no one to talk to so I start thinking that everyone(my ex, my son, everyone) is better off without me. I never leave my bed or my house very much(online schooling). I wake up all night and I never wanna get up in the mornings. I hate the thought of people not wanting me around. I cry all the time! I hate myself a lot/most of the time. The only time I leave my house is family events or my ex convinces me to go somewhere with him. I’m always in pain unless I’m venting to my ex. I mean emotional and physical. I just ache all over. I want to get better and need to for my son and ex(we might get back together later on and he’s my rock and I’m his and if I’m sick I can’t be there for him like I’d like). My ex is the only one that I know who knows about me thinking I’m sick because I don’t want to go to the doctors and have them put me on meds or something. Am I clinically depressed? Should I ask my mom to take me to the doctor to get help or am I fine? I need to know!!

An in-person interview, with a trained diagnostician, would provide the most accurate diagnosis but depression may be a realistic possibility. According to your letter, your symptoms include: a desire to isolate, physical and emotional pain, low self-esteem, and the consistent urge to cry. Those are common signs of depression.

Your symptoms are interfering with your life and they should be treated. To answer your question directly, yes, you should ask your mother to take you to a doctor. Being evaluated by a doctor does not mean that you will have to take medication. Many people who are receiving treatment for depression don’t take medication. Instead, they undergo counseling. With the right therapist, counseling is an effective treatment modality.

What are your next steps? Speak to your mother. Tell her about your symptoms. Ask her if she will schedule an appointment for you with either a primary care physician (PCP) or a local therapist. Consider seeing your PCP first to rule out possible medical problems. The PCP can then refer you to a therapist. If you choose not to see a PCP, the “find help” tab, at the top of this page, can help you to locate a therapist in your community.

The best way to find the right therapist is to call at least four or five and ask them various questions, including:

  • Can they help you?
  • How exactly would they help you?
  • What would they suggest that you do?
  • Would they be willing to see you and if so, how soon and how often?
  • How long have they been in practice?
  • Have they helped other individuals with similar problems?
  • What were the outcomes of those situations?

Choose the therapist who you feel most comfortable with and schedule an appointment. I wish you the best. Please take care.

Dr. Kristina Randle

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Best friend stealing boyfriend…bullies at school

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP August 7th, 2019
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

So my boyfriend lives 1,000 miles away from me and I see him three times a year. We are together and everything was absolutely great until three days ago. Three days ago my BEST friend started talking to my boyfriend and now all he does is talk to her…and he called her hot. My boyfriend barely talks to me anymore and when I bring up to him that what he’s doing is bothering me he accuses me of being rude and jealous. The problem is then he says I’m sorry and I love you. I love him too and that’s what is making this painful.

On top of that I just finished a very rough school year. I found out that one of my best friends started doing pot. I approached her and said that what she was doing is not right. She then flipped out on me and said that I was making up lies about her (I caught her smoking pot). She then totally bashed me in front of everyone and turned the entire school against me. Now I have about three friends. They even reported my facebook and now my facebook is locked. The other day at orientation she tried to corner me in the hallway and beat me up. I’m terrified to go back to school now.

I don’t even know what to do now. I feel like my life is falling apart around me and I don’t know what to do about it. My cousin who is like a sister to me is always depressed and I don’t want to end up being like her. Last year she told me that she was going to commit suicide. I stopped her from it and everything was ok again, but whenever I talk to her she tries to drag me down…what do I do?

These are very difficult issues for someone 13 years old to have to cope with. You are getting more than your share of the rough times right now. All of the things you have noted are annoyances that certainly warrant your reaction. None of it seems to be fair.

It sounds to me like you need to deepen your friendship with the three people you are close to as you expand your friendships to new people. I would also find an adult to talk to. The first place I would go is your school guidance counselor. He or she has a lot of experience with exactly these issues and can guide you through them.

You sound like a very responsible and loyal person, and it may be time to protect yourself from those people who aren’t treating you fairly. Stick with your friends that have been there for you, make some new ones to replace those treating you poorly, and talk to your counselor or trusted teacher about what is going on.

Wishing you patience and peace,
Dr. Dan

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Do I have any mental condition?

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP July 17th, 2019
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I’m not sure if I have a mental problem, and this is the closest I can come to figuring it out. I have a lot of weird things happening to me, here’s what they are.

-I cannot talk to people at all. It is extremely difficult to leave my house for this reason. If someone asks me if I want to go outside, the anxious feelings begin from there, and then get worse and worse as it gets closer to going outside and when I do go outside I get feelings of anxiety, nausea, heart racing, shaking hands, worried thoughts that people will laugh at me, stare at me, etc. and a lot of the time, I chicken out and stay inside. I can’t even sit on my porch or go in my backyard without these feelings. I had no friends in high school for this reason. I was awkward and had no social skills, no idea of eye contact, and no conversation skills. I worried the whole school day that every person who passed me was laughing at me. Because of all this anxiety, I began to have a strange demeanor. I would be stiff from head to tow, whenever I walked passed people I would “forget” how to walk normally and it felt like I was wearing cement shoes, I looked down because I “didn’t know where to look” when walking through the halls. I ended up staring at people in the eye. I also ended up staring and it felt like I was in a dream, like it wasn’t reality. I got this weird glaze in my eyes, some people said it looked like I was on drugs or that I was zoning out 24/7. In class I became so uncomfortable that I remained in the same position for the whole class period. I would be like a statue and almost never move. Before I moved, I obsessively planned how to move and how to place my hands, my feet, etc. I pretty much lost all that “naturalness” that humans have, before I made any movement I had to plan it. I also analyze a lot. How people look at me, how they say it, everything has a meaning to me so I notice things that most people don’t because of this. Weird thing is, I am like a social butterfly around only my family and have none of these symptoms with them.

-I also get really mad at people, then really happy at other times. After I get mad, even for the smallest things, I feel terrible for yelling at them. Other times I’m extremely happy and feel hopeful.

-I think people can read my mind. I tell myself it’s so stupid to think like this but still feel its true. I feel my prior bullies from school hid cameras in my house and watch my every move. I feel like they can see everything I do on the computer.
-I am very paranoid. I think my siblings always talk about me. I think everyone, including my extended family hates me because I act in that weird, uncomfortable, awkward way around him or her. I think every person in every car that passes by is staring at me through the rearview mirror or side mirror.

-I’m pretty sure I feel depressed a lot. It comes and goes each day. I get intrusive thoughts. I think bad things about my religion and family and these thoughts deeply disturb me. I get really upset when these thoughts pop in my head. I get some odd like symptoms when I get these thoughts to prove that I don’t believe these thoughts. Like entering a room over and over until the intrusive thoughts stop.

-My confidence in myself is always really low. I don’t think I can accomplish anything. I can never take any criticism, when I get criticized I get pretty depressed.
-I feel like any emotion is stupid. I feel embarrassed and stupid when I feel anything, happy, sad. I can’t even stand it when people congratulate me; I get uncomfortable when they do. I hate to cry and try to hold a lot of emotions in.

Please let me know if I do have any mental condition. I think knowing I have something would be a step to change my life, and I cannot go to a therapist due to my fear of going out.

First let me thank you for taking time to express your concerns in such detail. It sounds like it has been very difficult for you to manage. But there are very good things embedded in your concerns.

First there is the fact that your behavior is radically different at home than out in the world. This means that you have the skills, but there is something that is inhibiting you when you are in public. This is a good thing because it means you have the ability and need to learn how to use them in places other than with your family. This is a different issue than if someone wasn’t able to have these skills in any arena in their life. They would have to learn from scratch how to interact. This isn’t your situation. You know what it feels to be engaged, and when you are shut down. This is a better starting point.

Secondly, the part of you that is observing you to be this way in public is very astute and knows that the public behavior isn’t the true you. You are able to observe these aspects of yourself with depth and clarity. This self-reflection is the most essential ingredient to making changes.

While going out may not be an option you can get help from our forums, or from our online therapists. This would give you regular places to talk and learn about how to bring about change.

Wishing you patience and peace,
Dr. Dan

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Boyfriend cannot reach an erection with me

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP October 6th, 2019
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I have been with my boyfriend for two and a half years now. During the first 8 months of our relationship we had sex almost everyday, our relationship was amazing. Then in the end of September I found out that he cheated on me, I was devastated so we broke up. Two months later we got back together and I noticed that our sex life fizzled. We still had sex but not nearly as much. While we were broken up he had sexual relations with other girls and I wonder if those other girls made him less sexually attracted to me? Well, zoom past a year later in November in 2010, he broke up with me for reasons that I’m still not sure about, he basically gave me the, “its not you, its me” speech. Towards the end of December, we started back talking and I thought that we were going to get back in a relationship but then he explained to me that he met another girl that he liked and who he thought was more attractive than I am and went on to explain that he didn’t I pretty That crushed my self-esteem because all of that time I thought we had relationship problems because of my actions but never my looks. After that I hated looking at the mirror at myself because I thought/think that I’m ugly and the only time that I did look in the mirror was to scrutinize my flaws and point out exactly what made me not pretty. A month later, my boyfriend came back and said that he made a mistake and that he didn’t think that I was ugly and that he loved me and wanted to be back with me. So, since then we’ve pretty much been in an open relationship, we’ve been back together for about 6 months and they have been amazing but he never ever wants to have sex with me and when we try he isn’t able to reach an erection. He explains that it isn’t because he doesn’t find me sexually attractive and that he doesn’t know what the problem is. Since we are in an open relationship, he isn’t able to have sex with me but he is able to with other girls. I still feel like he doesn’t think that I am pretty or find me sexually attractive but we have got into plenty of arguments where he argues that he thinks that I am. I don’t know what to do because I want our relationship to work but I don’t think that it will be able to if he can’t have sex with me. We’ve only had sex one time since we’ve gotten back together and I don’t want to have sex with other guys. I want a normal relationship. Do you think that the reason he cannot get or keep an erection with me is physical or psychological and what can we do to overcome this barrier? I am in love with him and he is my best friend. I don’t want this to be the cause of the end of our relationship.

Thank you for writing to us. The easiest way I can convey what I am about to say is that it is time to move on.

Open relationships do not work. It is as simple as that. They have limited value as a transitional stance, but ultimately the very human factors of security, intimacy, and self-esteem eclipse the transitional stance. If they work at all it is because they prevent deeper intimacy, not promote it. For those who want to keep intimacy at bay an open relationship will do the trick.

That having been said, your relationship does not sound truly open. You have not mentioned your side of the equation. If he is having sex with other women, are you having sex with other men? If not, why not? If it is because you are hoping to be faithful and that he will eventually curtail his other relationships, history would dictate you are wasting your time.

He doesn’t sound like relationship material. If intimacy is what you are looking for, find a person who is willing to be connected to you in a way that mirrors how you are connected to him. If you haven’t tried some individual counseling, you can use our find help tab at the top of the page to find someone in your area.

Wishing you patience and peace,
Dr. Dan

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